Impact of early engagement of patients with clinical trial information in a system-based multidisciplinary breast cancer clinic on clinical trial enrollment.

Abstract

149 Background: Cancer clinical trial enrollment is low at approximately 3% in the U.S., and there is an urgent need for improvement. Informing patients clinical trial information early at their initial appointment after the diagnosis of cancer may improve clinical trial enrollment. To this goal, we have developed a system-based multidisciplinary breast cancer clinic (MDBCC) that evaluates all newly diagnosed breast cancer cases and discuss with all patients eligible clinical trials at their initial appointment. Methods: Our MDBCC team consists of a medical and radiation oncologist, breast surgeon, mammographer, pathologist, geneticist, and breast cancer coordinators, who review all newly diagnosed cases in the tumor board (multidisciplinary breast cancer tumor board) prior to patient’s MDBCC appointment. During the MDBCC visit, each individual patient meets separately with a medical oncologist, a radiation oncologist, and a surgeon to discuss their treatment options. Eligible clinical trials are discussed and presented to patients with informed consent. Clinical trial nurses are dedicated for patients to call and meet for further discussion on the eligible trials after the MDBCC visit. Results: The average annual clinical trial enrollment for breast cancer was 9 cases (approximately 3%) between 2000 and 2006 prior to initiating the MDBCC, improved to 53 (approximately 17%) between 2007 and 2011 after the MDBCC was formed. The enrollment into the NSABP and SWOG trials accounts for the large portion of the accrual. Conclusions: Early engagement of patients with clinical trial information in a system-based MDBCC for all newly diagnosed breast cancer patients dramatically improves clinical trial enrollment.